心脏移植体外循环转流(附9例报告)

EXTRACORPOREAL CIRCULATION IN HEART TRANSPLANTATION: A REPORT OF NINE CASES

目的总结9例心脏移植病人的体外循环转流经验。方法体外循环采用中度低温、轻度血液稀释法。供心保护采用晶体心肌麻痹液停搏,供心取下后UW液灌注,并将其保存于UW液内。结果9例手术病人脱离体外循环顺利,后期死亡2例。结论应严格掌握受体手术适应证,对术前并发肾衰竭病人行心脏移植要慎重考虑。良好的供心保护,体外循环过程中各项重要生理指标的监测和超滤的应用是顺利脱离体外循环的关键。

Objective To describe the extracorporeal circulation （ECC） in nine cases of heart transplantation. Methods Moderate hypothermia and slight hemodilution were used during the ECC. The cardioplegia of Thomas was delivered for the protection of donated heart. The removed heart was infused with and stored in UW solution. Results Nine patients got out of ECC smoothly, of whom, two died later. Conclusion The indications of the surgery should be strictly controlled , and for those with renal failure have to be considered carefully. Good protection of the donated heart, monitoring of important physiological signs and application of ultrafiltration are keys to the smooth breaking away from ECC.